Hemoperfusion in toxicology. Basic considerations of its effectiveness.

The indication to use hemoperfusion as a therapeutic measure in severe intoxications in man should be based on a three-step evaluation. First, the ability of an adsorbent to eliminate the poison from human blood has to be known. Second, the distribution volume has to be small and the spontaneous half-life of the poison has to be relatively long, such that lowering the toxic blood level results in a concomitant decreasing tissue concentration. Third, studies in poisoned patients have to prove that it is possible by hemoperfusion to lower the total body load to a toxicologically relevant extent.